Down There Care

PMS + PMDD: The Science Behind Those Mood Swings, Cramps & Cravings

By Gabi Powell Janaya Britton

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It’s that time of the month again. That moody, bloated, crazy-craving, cramp cocktail that starts right before your period touches down, here to let you know Mother Nature is making a comeback. UGH! Don’t you just hate that?

PMSing isn’t a crowd favorite, but, Betties, we’ve gotta feel the feels to let the flow flow. Understanding your cycle and symptoms is an important step to understanding your body and advocating for your care needs!

But…what exactly is PMS? And what if your experience is more intense than the average? Our experts are here with the answers. Let’s dive into the ins and outs (and ups and downs) of hormones, PMS, PMDD and why tracking your cycle is a Betty’s must for down-there-care.


Premenstrual Syndrome (PMS)

PMS or Premenstrual Syndrome is a cluster of symptoms that show up somewhere around five days before your period. Mild PMS is especially common, Betties, and you’ve probably experienced one or more of its symptoms:

Physical Symptoms: thirst and appetite changes (food cravings), breast tenderness, bloating and weight gain, headache, swelling of the hands or feet, aches and pains, fatigue, skin problems, gastrointestinal symptoms, abdominal pain.  Emotional Symptoms: depression, angry outbursts, irritability, crying spells, anxiety, confusion, social withdrawal, poor concentration, insomnia, increased nap-taking, changes in sexual desire 


In other words, that two-in-the-morning-tub-of-ice-cream sesh, or middle-of-the-day meltdown or that out-of-the-blue breakout? Yup, those could be a sure sign of PMS, especially if this experience is your month-to-month norm. Think of these expressions like your body’s weather forecast, giving you a heads up that your period is on its way.



But to understand why PMS has you feeling some kind of way, you first need to understand what is happening in your body during your cycle.


Menstrual Cycle 101

The menstrual cycle lasts somewhere between 21-45 days.



Now, the word “cycle” doesn’t just apply to when we’re bleeding, but involves allllll the hormone fluctuations we can’t see happening inside our bodies that impact how we feel – physically, mentally, and emotionally. Here’s how the story goes:


WheN: Day 1
WhAT: Enter: Bleeding! Betties’ periods begin with shedding blood and endometrium (the lining of the uterus). This phase lasts anywhere from 3-7 days. Flow period (😉)varies Betty to Betty, and there’s a wide range of what is “normal.”

Follicular Phase

WheN: Days 1-14
WhAT: Follicles are recruited to grow in your ovaries! Estrogen is produced, increases steadily, and spikes around Day 14.


WheN: Day 14
WhAT: An egg is released from the ovary to be (or not to be) fertilized by a sperm as it travels down the fallopian tube. Estrogen levels are at peak levels!

Luteal Phase

WheN: Day 14-28
WhAT: A Betty’s body tries to prepare for an egg’s fertilization. Progesterone steadily increases over the next two weeks.
*dun dun dun*
Betties, this is the hormone shift, during the luteal phase, where PMS symptoms make their (unwelcome)entrance and have you feeling, bloating, craving and cramping. Ugh. Next phase, please!

End Cycle

WheN: Day 28
WhAT: If pregnancy doesn’t occur, hormone levels decrease, uterine muscles contract and the endometrium is shed. Wait…haven’t we done this before? Sure have! We’re back to Day 1 with menstruation. Wash, rinse, repeat!


You see, our brains and ovaries are constantly chattering throughout our cycles to communicate hormone levels. Without the regular fluctuation of hormones, the menstrual cycle couldn’t work properly.

And much like how long a cycle will last, how much these hormones will yo-yo during a cycle will be unique to every menstruator. Tracking how you feel – physically, mentally and emotionally – is the best way to establish your cycle’s unique baseline. PMS is a really common experience, so most Betties experience the not-so-great side effects on a normal spectrum. But for some, the hormone fluctuations can be extreme and life-interfering.


Premenstrual Dysmorphic Disorder (PMDD)

Premenstrual Dysmorphic Disorder or PMDD is a severe type of PMS. Yikes. What do you mean severe?
Yup. Think PMS – the bloating, fatigue, irritability, and body aches – but with the dial turned wayyyyy up. None for me, thanks.

PMDD can be tricky to diagnose because symptoms often mimic those of mental health conditions, such as depression or anxiety disorders (Though it’s important to note PMDD can coexist with a mental health disorder!). What’s more, the cyclical nature of both PMS and PMDD (i.e. that up-down-up-down of hormones each month), means providers have a “chicken or the egg” headscratcher on their hands when it comes to making a diagnosis.

This is why Betties should loop in their provider stat if they experience severe symptoms, because it’ll take some time to assess your cycle – evaluating core symptoms, the timing of those symptoms and how long they’ve been occurring – to create a care plan for your whole-body health.


Is there anything I can do to relieve PMS symptoms?

You betcha, Betties! DIY some relief with these self-care measures:


Work up a sweat

Consistent exercise (not just when your cycle’s in session!) can reduce the blues and fatigue that come with some Betties’ PMS.



Relaxation a lá yoga, meditation, or breathing exercises can help lessen stress, and in turn, soothe some of those pesky PMS symptoms.



These foods can exacerbate the PMS yuck, so limit your intake during your cycle.



Some common NSAID medications are ibuprofen (You might know ‘em by a brand name: Advil or Motrin) and naproxen (aka Aleve).


And what if lifestyle modifications don’t provide relief?

You don’t have to suffer through your symptoms, Betties. Providers can treat PMS and PMDD with medications, which usually include:

• ssris: Selective Serotonin Reuptake Inhibitors (SSRIs) are a group of medicines used to treat depression + anxiety. For Betties with PMDD, SSRIs lend a helping hand by decreasing sensitivity to that rollercoaster of hormones and re-upping those mood-related neurotransmitters.
• birth control pills: BC controls hormone fluctuations that contribute to PMS/PMDD. Your provider will be able to recommend a birth control method match to fit your symptoms + your body + your lifestyle.


Betties, down-there-care shouldn’t feel like a downright chore.

Tracking your cycle is one of the best tools for body literacy and allows you to learn your “normal.” By taking note of your mood, physical, and mental well-being throughout the month, your provider has the insight to spot any PMS patterns + treat your period pains.

Every month, our bodies and brains self-activate and link up for this hormone sequence that makes our cycles possible. (Every month! How cool is that?!) So, if these cycles are going to be repeat visitors, we owe it to ourselves to learn how to best live with them and the side effects they bring.


That’s where Betty’s Co. comes in.

Our team of women’s health specialists, wellness experts and counselors practices integrative care – meaning, your whole-self health is considered for every health concern you bring to a care visit.

Be well and book your appointment today!



Medical Contribution: Lindsey Lavoie, WHNP + Jillian LoPiano, MD, MPH, FACOG


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